Lithium side effects

What Side Effects Can Lithium Have?

Below you will find the most important information about possible known side effects of lithium.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).

Common side effects:
Weight gain (dose-dependent).

Occasional side effects: nausea and vomiting, diarrhea, increased urination, gastritis, dry mouth, saliva production, muscle weakness, muscle pain, joint pain, tremor, muscle twitching, involuntary movements of the arms and legs, movement disorder, tendon reflex increase, unconsciousness, seizures, speech disorders, coordination disorders, Headache, dizziness, drowsiness, clouding of consciousness, memory loss, loss of activity (while maintaining consciousness), coma, hallucinations, taste disturbances, involuntary eye movements, visual field defects, fake tumor formation in the brain, blurred vision, impotence, sexual disorders

Rare side effects:
cardiac arrhythmia (usually slowing down), circulatory failure, low blood pressure, ECG changes, fluid retention (edema), vascular spasms, circulatory disorders (on hands and feet)

Very rare side effects:
hair loss, skin disorders (similar to acne), hair follicle inflammation, itching, psoriasis (spread), mucosal swelling (in the mouth and throat), hypersensitivity reactions (skin rash), goiter, hyperthyroidism, hypothyroidism, increase of Blood sugar levels, hyperparathyroidism, increase in calcium levels, anorexia, increase in white blood cells (leukocytes), reduction in sodium levels, reduction in potassium levels (within a week, the sodium-potassium concentration should return to baseline), water balance disorder, incontinence !!!

Undesirable effects:
benign kidney tumors and kidney cancer (in long-term treatment).

Special features:
Predominantly at the beginning of treatment:
subtle tremors, urination, thirst, nausea. Most of these undesirable effects are resolved by continuing treatment or reducing the dose.

What interactions does lithium show?

Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).

Antiepileptic drugs such as phenytoin, carbamazepine, methyldopa and tri-and tetracyclic antidepressants increase blood levels of lithium and increase the risk of nerve damage. Also diuretics such as thiazides and other potassium-sparing dehydrating agents as well as loop diuretics lead to an increase in the lithium level and thus to an increase in the effect. The antibiotic metronidazole, non-steroidal anti-inflammatory drugs such as indomethacin, hypertensive ACE inhibitors such as captopril or enalapril as well as antihypertensive calcium channel blockers such as diltiazem or verapamil can even increase the potency of lithium so much that it causes poisoning.

On the other hand, other diuretics from the group of carbonic anhydrase inhibitors, such as acetazolamide, lower blood levels of lithium and weaken its action. This also applies to urea, acid-binding agents and xanthine derivatives such as theophylline and caffeine (in coffee).

Antibiotics from the group of tetracyclines can increase or decrease the lithium level.

The concomitant use of neuroleptics (haloperidol, chlorpromazine or clozapine) leads, especially at high doses, to a high incidence of adverse reactions. The combination with MAO inhibitors and selective serotonin reuptake inhibitors can also lead to increased awareness, restlessness, muscle twitching, increased reflexes, sweating, shivering and trembling. In this case, discontinue the entire treatment and, if necessary, initiate a hospitalization.

Lithium prolongs the action of muscle relaxants, such as those given before surgery. Treatment with the drug should therefore be discontinued approximately 48 hours prior to surgery.

Alcohol tolerance is attenuated by lithium.

Potential Lithium side effects may include: